| Doctor Name: | MRS. LINDA MARIE WILSON |
| NPI Number: | 1053559179 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 4126 |
| Business Practice Address: | 6700 W 44th Ave Wheat Ridge, CO - 800334732 |
| Business Phone Number: | 3034208080 |
| Business Fax Number: | 3034209299 |
| Mailing Address: | Po Box 140901, EDGEWATER |
| State: | CO |
| Postal Code: | 802140901 |
| Phone Number: | 7203187321 |
| Fax Number: | 3039556721 |
| NPI Enumeration Date: | 01/27/2009 |
| NPI Last Update Date: | 01/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4126 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |